Joshua Stott, clinical psychologist and professor at University College London, explores the relationship between childhood ADHD traits, health and well-being using the British Cohort Study.
Until recently, attention deficit hyperactivity disorder (ADHD) was widely viewed as a childhood condition. Growing evidence now shows that its effects on health, wellbeing, and social outcomes can continue well into adulthood, with significant costs for individuals and society.
Studying these long‑term pathways has been challenging, partly because the diagnosis ADHD—and its predecessor, attention deficit disorder (ADD)—only became formally recognised in the 1980s.
Using data accessed through the UK Data Service, we have begun to address this gap.
A new way to measure childhood ADHD traits
This work started when my collaborator, Dr Jo Cotton, developed a new way to measure childhood ADHD traits using the 1970 British Cohort Study.
What is the 1970 British Cohort Study?
The 1970 British Cohort Study, accessible through the UK Data Service catalogue, follows the lives of 17,000 people born in a single week in 1970 across the UK.
The cohort members of this study, along with their parents and teachers, have completed questionnaires and assessments at 11 points across their lives.
Each sweep of the survey covers a range of information about participants’ health, education, relationships and social development to name just a few.
Because ADHD traits were not directly measured in childhood, Jo examined the parent and teacher questionnaires completed when the cohort members were aged 10–11.
She identified questions that best mapped onto modern diagnostic criteria used in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), the most widely used psychiatric classification system. For example, one item asked parents whether the child “often has trouble holding attention on tasks or activities.”
After identifying all relevant items, Jo refined and combined the most informative ones into a single ADHD‑traits scale using a statistical method called item response theory.
We now use this measure to explore what happens to children with high ADHD traits as they reach midlife.
Why is this important?
Focusing on traits—rather than formal diagnoses—is important in this cohort because ADHD was not a recognised diagnosis when the childhood data were collected.
Our previous work also shows that most adults born in 1970 who meet criteria for ADHD today have never received a diagnosis and therefore remain unrecognised.
What does the British Cohort Study tell us about the relationship between ADHD traits and wellbeing?
Our work using the 1970 cohort to explore the long-term consequences of ADHD is ongoing.
Recent findings include a study published in JAMA Network Open, where we showed that children with high ADHD traits at age 10 were more likely to experience physical health problems and health‑related disability at age 46 than those without such traits.
These associations were partly explained by factors that are both more common in ADHD and known to affect physical health—such as higher body mass index (BMI), elevated psychological distress, and smoking.
In another study, published in Nature Mental Health, we found that people with high childhood ADHD traits were more likely to experience psychological distress at every assessment point between ages 26 and 46.
Importantly, we uncovered a key role for the societal response to ADHD, as opposed to ADHD itself, whereby distress at age 46 was linked to forms of societal exclusion, including reduced access to health services, weaker social networks, lower engagement in economic activity, and barriers to public services.
What can we conclude from our work so far?
Although we cannot draw firm conclusions about causality, the evidence so far suggests that the impacts of ADHD on physical and mental health extend into midlife and beyond.
Crucially, many of the contributing factors appear to be modifiable.
For example, targeted smoking cessation support for people with ADHD traits may improve later physical health, while improving inclusion within health services—such as through reasonable adjustments—may help reduce later psychological distress.
About the authors
Joshua Stott is a Professor of Ageing and Clinical Psychology at University College London (UCL) and Director of the UCL Autism, ADHD, Dementia, Aging and Psychological Therapies (ADAPT) lab.
Joshua is also a HCPC registered Clinical Psychologist with 20 years of post-qualification clinical practice experience working with people affected by dementia. He is an honorary consultant clinical psychologist leading a clinic at the UCL Dementia Research Centre.
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